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By Jennifer Browning

The final pieces are being put in place to finalize the Akamil Production Facility in Thomonde. Ground breaking began June 2007 for the construction of the facility, but construction and final equipment installment was delayed after the January 12 earthquake. When production begins, it will mean so much to rural Haiti and those Project Medishare serves in the commune of Thomonde.

DSM's Marienella Mendez, Project Medishare's Laurene Leger, and CDC's Mike Kaiser in front of the Akamil Production Facility in Thomonde. “ I am really surprised and I am really amazed at the job Project Medishare is doing here. Medishare is motivating Haitians to do things by themselves.With this project you involve the local community, the international community and private industry all together in a project that has sustainability,” Mendez said. “It is difficult to find projects like this that involves the entire community.”

Three years ago Center for Disease Control (CDC) Senior Fellow Mike Kaiser met with then Project Medishare Executive Director Ellen Powers and began brainstorming about producing Akamil, a fortified nutritious supplement created by locally grown ingredients. Since then, with the combined support of Project Medishare President Dr. Barth A. Green, Co-founder Dr. Arthur Fournier, Country Director Marie Chery along with numerous supporters, the production facility became more and more of a viable reality. Today, Kaiser and Chery are putting the final touches to the plan.

The CDC’s role in the project is to research and document whether the Akamil project is successful or not.

Kaiser said the Akamil Production Facility is a great grassroots effort and supports Project Medishare’s mission in the Central Plateau.

“It has the value of creating jobs for the farmers……and you are going to fortify something they like to eat, instead of something you are trying to make them eat,” Kaiser said. “[Akamil] is an indigenous food that [the people] already like and know.”

Akamil when mixed becomes a porridge that people can mix sugar and fruit with in the morning or can mix with salt, vegetables and meat in the evening.

“It becomes a staple food that can be fully nutritious, but the full-circle idea is that you are creating jobs for the farmers to then grow the crops and they now know that someone will purchase the crops if they grow more than what they need for just themselves,” Kaiser said. “The Akamil plant can buy it from them.”

To help make the Akamil project successful, the University of Florida provided technical assistance through Project Medishare’s agriculture extention agents by providing training at Project Medishare’s demonstration farm and local farms around the community.

But Kaiser pointed out that it isn’t just the community farmers who benefit from Akamil. Women in the community, benefit as well.

“The other part is that you are creating jobs in the factory, creating jobs in the sale and distribution of the product,” he said. “We’ve talked about microlending with women—creating opportunities for women, which is a real big deal in Haiti, because right now the women don’t have the rights and the respectability that they deserve.”

Kaiser added not only will Akamil benefit the community Project Medishare serves, but more importantly, that same community fully supports the project.

“The enthusiasm that has been generated locally is incredible,” Kaiser said. “This is all being done locally.”

The sale of Akamil doesn’t stop in the commune of Thomonde.

“The international community has said they will purchase Akamil to use in school feeding programs,” Kaiser said, “and thanks to all the donors who have contributed to this project, there is no overhead and the plant will be able to produce and sell the product at cost as a not-for-profit enterprise.”

One of those contributors is DSM who has donated the vitamin-fortified pre-mix for the Akamil product.

The pre-mix for Akamil contains Vitamin A and B complex (Thiamin B2, b12), Iron and Zinc making it a complete formula that can be consumed by the whole family from children to adults. Iron and zinc helps with anemia as well as the immuno process, and additionally these nutrients help to improve the growth rate in children.

DSM manager Marienella Mendez said her company became involved with Medishare through AzkoNobel, a supplier of iron. AkzoNobel contacted DSM and asked to assist Project Medishare with the vitamin supply and pre-mix.

But DSM not only decided to donate the pre-mix, they wanted to participate further by providing technical assistance.

“We wanted to participate in the complete process to be sure the pre-mix is going to be used in the right way,” Mendez said. “We have a social responsibility with our products. We need to make sure that the people taking these vitamins that their bodies are absorbing them the right way. We have the responsibility to ensure the product is being used correctly. In order to obtain the right product we are helping make sure that the vitamins and minerals are created at the right levels.”

After this Mendez and DSM will join Kaiser and the CDC in formulating a nutrition survey, which will be managed by Project Medishare’s community health agents.

Mendez said the goal is first to give Akamil to 300 families and six month later these same families go in for blood tests to monitor the levels of iron and other nutrients. Community health agents will continue to test the families once a month to monitor nutrition levels. Afterward, Akamil will be offered to the whole community and will also be available for other NGOs to purchase for their programs.

Mendez said the nutritional survey is an important part of the process.

“This kind of test has to be done to sort of close the circle because when the kids or the families eat the Akamil we need to ensure the levels are good for them and will produce positive changes in their body and in their metabolism,” she said. “This helps us continue to make sure the right levels of the vitamins end up in the body and actually helps improve their nutrition.”

The nutritional surveys, according to Kaiser, are an essential part of Akamil’s business plan. And thanks to AutoGov and Motion Computer for donating data software, Blackberry’s and digital tablets, information collected by the community health agents will be available immediately.

“That information is creating electronic medical records which can be communicated to the local doctors, local clinics and it is immediately provided to the Ministry of Health,” Kaiser said. “People don’t have to wait two or three years for the results of a nutrition survey, which is typically how it is done. All of this information will be available immediately thanks to AutoGov and Motion Computing.”

In addition to the local medical community having instant access to information, the Ministry of Health will also receive these electronic medical records.

“[The Ministry of Health] are really excited that they are going to receive electronic medical records and they are going to have this way to collect information,” Kaiser said. “For Medishare, because we have done this nutrition survey, someone else can come in and conduct future health surveys because all to the equipment is there.”

“And now they are collecting their own data, and they don’t have to rely on the Pan American Health Organization (PAHO) to collect it for them, which always takes time,” Kaiser said. “Now [the Haitian people] can do it themselves, if we can teach them….and they can, and this is happening right here. We really are taking this concept of don’t give them a fish, but teach them to fish. That is what we are really doing from the beginning.”

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By Jennifer Browning

Thirty-five seconds. That’s how long it took for the earthquake that hit Port-au-Prince on January 12 to destroy 60 percent of Haiti’s capital, level all government ministries, kill over 250,000 and make over 1.5 million homeless.

In Thirty-Five Long Seconds: Haiti’s Deadly Earthquake, producer Mario L. Delatour, takes a look at the history behind the government buildings that were destroyed that day, as well as the people of Haiti and how they have persevered natural disasters in the past.

Delatour also touches on how over 500,000 people fled into rural Haiti seeking shelter, food, safety, and now, work, thus proving that the earthquake is a national disaster, not one that only affects the devastated capital city of Port-au-Prince.

Shown at the Haiti Donors Conference in Washington, D.C. in March, the video consists partially of footage from security cameras inside Haiti’s National Palace, it is very hard to watch, but tells an important story of tragedy and hope for triumph to rebuild.

The video features Haitian government officials including President René Preval and First Lady Elizabeth Preval, Haiti’s Prime Minister Jean-Max Bellerive, and Patrick Delatour, the Haitian minister of tourism about what they experienced and what the Haitian government thinks their country needs to rebuild, recover, and be a better Haiti.

We should not forget that rebuilding Haiti will take a very long time and that continued assistance is necessary.

If you would like to help Project Medishare continue providing medical assistance through out Haiti click here to donate today.

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By Jennifer Browning

While the impending rainy season makes life difficult in our field hospital in Port-au-Prince, the same rain helps seeds turn to much needed food.

For the past three years, through the Integrated Community Development Program, Project Medishare has been working to improve agriculture in the Central Plateau.

As part of the program, our local agronomists work with area farmers to help them improve farming practices so their fields will yield better crops.

In 2008, the Food and Agricultural Organization of the United Nations (FAO) donated 220 earthboxes through the FAO’s Growing Connections Program. Project Medishare is received not only assistance from FAO but also from the Institute of Food and Agricultural Sciences at the University of Florida (IFAS) who continue to provide techincal assistance to our agricultural program.  The program is an effort to begin an alternative growing program for the vulnerable (elders, sick, handicapped), children and adolescents.

Project Medishare’s agronomist, Ronal Bien-aimé and IFAF’s Florence Sergile tested the Earth Boxes by seeing how they would adapt to local conditions. The agronomists monitored and compared the plant growth being tested in the Earth Boxes with those planted in a field.

With the success of the program, the agriculture team expanded the experience into the community. Ten Earth Boxes went to Marmont and were placed in the yard of the local clinic where visitors and patients can see the possibilities of alternative gardening, and the link between nutrition and good health.

In June 2008, Project Medishare provided training to the Haitian staff and consultants with the Food and Agricultural Organization of the United Nations (FAO) introducing FAO Haiti to the agriculture program of the Project Medishare Integrated Community Development Program in Marmont.  Demonstrations and trainings were done for local women at the trial farm as well as in the community.

Last year, our agriculture team began working with IDEJEN (Young Idea), a group of 25 adolescents as part of the community expansion. IDEJEN assisted Project Medishare’s agriculture team by receiving hands on training with 25 Earth Boxes. The group, which is comprised of at-risk youth in the community, continues to work with our agriculture team.

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The final piece of equipment arrived at the Akamil Production Facility in Thomonde. Project Medishare's construction team will soon begin to put all the equipment in place so we can start working towards a production date. Project Medishare is bringing in a technician to provide training. Photo by Jennifer Browning.

By Jennifer Browning

The last piece of equipment required for the Akamil Production Facility arrived in Thomonde last week.

Project Medishare is now in the process of putting all the equipment in place, so that we may start working toward a production start-up date. In the meantime, our staff is arranging for a technician to come to provide training on how to use the equipment properly. Once the technician arrives the facility will be operational and Project Medishare will begin conducting trials on all the equipment.

Soon all the equipment will be put in place and tile layed out along the floors inside the Akamil Production Facility. Photo by Jennifer Browning.

For the past three years Project Medishare has been a part of this hopeful spirit of progress and change in Haiti. Medishare has been working toward a long-term solution regarding hunger and malnutrition in Haiti’s Central Plateau, starting with the community of Thomonde. Project Medishare has been working toward specifically solving the malnutrition problem in Haiti with the construction of the Akamil Production Facility and Nutrition Complex. Construction of the facility began over two years ago and despite severe hurricanes and the recent earthquake, the Akamil Production Facility is finally complete.

Before the earthquake, Project Medishare planned to begin production of Akamil in late-January, however the final piece of equipment was held in customs long after the earthquake. Project Medishare staff for a while feared that the equipment had been damaged in the quake, but it was tucked away safely in the crate and has now arrived in Thomonde.

The Akamil Production Facility will manufacture and distribute AKA1000, often referred to as Akamil (Nutrimil), a mix of locally-grown products such as cereals (rice, corn, millet, wheat) and vegetables (beans) all blended into powder. It is a product of great nutritious value containing building and energetic nutrients, and is affordable to poor families. With the expert consultation of a nutritionist, the finished product will be fortified with a mix of important vitamins and minerals such as iron, zinc, and Vitamin A.

With the recent migration of earthquake victims from Port-au-Prince, Project Medishare’s  population in Thomonde has increased by 29 percent. In Marmont, our population increased by 18 percent. This increases a burden on an already overstressed area when it comes to healthcare and food consumption.

The Akamil Production Facility will not only help battle malnutrition in the Central Plateau, but provide additional jobs for locals in Thomonde and surrounding communities. Project Medishare will also purchase produce from local farmers that will be used as part of the ingredients for Nutrimil (Akamil).

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By Jennifer Browning

Two weeks ago Hand in Hand for Haiti traveled to Thomonde to visit Project Medishare’s Community Health and Development program.

The Moodie Report, which documents the organization’s project, reported that while there are no easy solutions to Haiti’s problems, that Haiti needs fighters like Project Medishare’s Country Director Marie Chery and “powerful organizations such as Project Medishare who will battle seemingly insuperable odds to create a better Haiti.”

What Martin Moodie is referring to is Project Medishare’s long-standing work in the Central Plateau.

In 2003, Project Medishare started a process to implement a community

Rosemerline Pierre-Louis, community health nurse and coordinator for Project Medishare's PEPFAR grant, checks vitals of a young patient during a mobile clinic visit in Savanne Perdu. As part of the Community Health Program, Project Medishare staff conduct mobile clinics to hard to reach areas like Savanne Perdu in the Central Plateau two to three times a week. Photo by Jennifer Browning.

health program in Thomonde. This program was financed through a three-year grant from the Green Family Foundation. Today, Project Medishare has over 95 local staff of Haitian doctors, nurses, LPN’s, health agents, and administrative staff to provide this care. It includes managing the Ministry of Health clinic in Casse (Lahoye) and conducting a community health program with rally posts, mobile clinics, home visits, community meetings, vaccinations, nutritional monitoring, and providing oral rehydration solution, vitamin A, iron tablets, and anti-worm medication.

In 2008, Project Medishare began collaborating with the Government of Haiti, The University of Florida Institute for Food & Agriculture Sciences (IFAS) and the

As part of the Integrated Community Development Program, Project Medishare's agricultural team has been successful in working with community farmers to promote sustainable farming practices in the area. Photo by Jennifer Browning.

community of Marmont to undertake an integrated community-driven development program. The activities focus on achieving the Millennium Development Goals (MDG’s), which are aligned with the government of Haiti’s Poverty Reduction Strategy Plan, and promoting human security in impoverished rural areas through community based investment and community based capacity building. The program is in the pre-implementation, scoping stages and activities have focused on health, agriculture and education.

While Project Medishare is continuing to provide medical relief to earthquake victims in Port-au-Prince, it is important that our Community Health and Development Program continues to meet the goals set forth before the January 12 earthquake, especially with the recent exodus of earthquake victims who left to seek refuge with relatives in rural Haiti.

Click here to read the full Moodie Report about Hand in Hand for Haiti’s visit with Project Medishare.

If you would like to assist Project Medishare in Haiti click here to make an online donation.

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By Jennifer Browning

This weekend in the first of a two-part article, the Miami-Herald takes a look at rural Haiti and the government’s intentions to look toward decentralizing the country in order to give more power to the municipalities and provinces.

Rural Haiti has already experienced a mass exodus–over 400,000 people have fled to rural areas to seek shelter with family and other relatives. Later this month, Haitian leaders intend to outline a rebuilding plan during a critical aid conference in New York. The leaders are working toward a plan that will incorporate rural areas into the development of the country.

In addition to providing care for earthquake victims at the Project Medishare and the UM Global Institute Hospital in the capital, Project Medishare continues to provide ongoing support to our existing rural programs like the Community Health Program and our Integrated Community Development Program, which includes helping local farmers with better agriculture practices in the Central Plateau.

As resources in Port-au-Prince continue to dwindle, soon there will be another exodus to the countryside. Schools and health clinics will need to be built and funded to accommodate these urban guests who will more likely become permanent residents.

Click here to read the first of two parts of the Miami-Herald’s story about how rural Haiti is pushing for decentralization of power and resources.

In the coming months, we expect to see a continued growth in our rural communities of Thomonde and Marmont in the Central Plateau. If you would like to help us in continuing our support of our Community Health and Development Programs in Haiti’s Central Plateau click here.

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By Jennifer Browning

Within a two month period two earthquakes struck. On January 12, Haiti’s Port-au-Prince rumbled and roared when a quake the magnitude of 7.0 left the city in ruins and killing over 200,000. Early Saturday morning, a more powerful earthquake, an 8.8, rocked Concepcion, Chile causing widespread damage, destroying buildings, bridges and roads in many areas as far as Chile’s capital in Santiago. Electricity, water and phone lines were cut. So far 214 are reported dead.

Since Saturday morning scientist and journalist have been discussing why a smaller quake killed so many more and left behind more damage in its wake.

Colin Stark from the Doherty Research Scientist at the Lamont-Doherty Earth Observatory of Columbia University shares his opinion with CNN. A geophysicist and geomorphologist, Stark’s research is focused on the effects of typhoons and earthquakes on the triggering of landslides and the erosion of mountain rivers.

In his opinion piece Stark discusses that it was poverty, not necessarily the power of the quake that left Por-au-Prince in a pile of rubble and catastrophic misery.

“Poverty is what ultimately kills most people during an earthquake. Poverty means that little or no evaluation is made of seismic risk in constructing buildings and no zoning takes place. It means that building codes are not written, and even if they do exist they are difficult, or impossible, to enforce. It means the choice between building robustly or building cheaply is not a choice at all.

Haiti is a tragic illustration of this. Weak building materials and poor construction standards share much of the blame for the grotesque numbers of fatalities, injured and internally displaced people.

Of course it’s complicated. Earthquake shaking is a complex process and the chain of causation from earthquake source magnitude through infrastructural damage to human harm involves factors like the type of earthquake fault, its orientation, the hardness of bedrock or presence of wet soil, and so on. A lot also depends on the time of day the earthquake strikes in terms of how many people are inside buildings that could collapse. Population density, distance from the epicenter, and the depth of the rupture are the most important factors of all.

Nevertheless, those countries most at risk of seismic tragedy are not simply those on tectonic plate boundaries, but also those with the least money to spend on protecting themselves.”

Project Medishare has been working in Haiti since 1994 towards achieving quality healthcare for the Haitian people. Poverty has remained a large obstacle in working to achieve this for our organization as well as other NGO’s working in Haiti.

Three years ago, Project Medishare began working towards a plan to obtain funding to operate a Nutrimil (Akamil-AK1000) facility which will produce a fortified meal for those in Haiti’s Central Plateau. Nutrimil is produced from locally-grown products such as cereals (rice, corn, millet, wheat) and vegetables (beans) all blended into powder. It is a product of great nutritious value containing building and energetic nutrients, and is affordable to poor families. With the expert consultation of a nutritionist, the finished product will be fortified with a mix of important vitamins and minerals such as iron, zinc, and Vitamin A.

The Nutrimil facility in conjunction with the adjoining nutrition complex will be a part of working toward combating malnutrition, but also because the ingredients are bought locally, will help boost the local agriculture economy–thus together working toward fighting poverty as well.

Equipment for the facility was installed in November, and Project Medishare planned for the facility to begin operation at the end of February, but the earthquake has postponed the opening.

In the months and years to come, while Project Medishare works towards helping Haiti’s earthquake victims, we will also continue to work towards fighting poverty and malnutrition.

Click here to read more of Stark’s opinion piece on CNN.com which tells the tale of two earthquakes.

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